In accordance with the invention a sleeve-glove attachment assembly is provided for protective garments used in hazardous environments such as surgical hospital settings and testing laboratories as well as garments desiring a waterproof seal at the sleeve-glove interface such as underwater diving suits, motorcycle gear, and snow skiing apparel. Also, the invention may be used at orifices of garments other than the wrist including the neck and ankles. However an immediate need is obvious in the surgical operating room setting, so reference to this application will be explained in detail.
This invention relates to the liquid barrier properties of surgical operating room personal protective equipment (PPE). The barrier properties are vital to the healthcare worker because of bloodborne infectious diseases and deadly viruses such as Hepatitis C and HIV. Conditions like Hepatitis C do not currently have vaccines and post-operation prophylaxis, often resulting in fatal consequences. The safety of the patient undergoing surgery may also become threatened if the liquid barrier garments of the caregiver are not sealed, especially at the fingers, hands, and wrists. Presently, surgical gowns and surgical gloves exist that provide safe liquid barriers as independent devices. However, the surgical glove-gown sleeve interface is the weakest link of all PPE because the glove and gown do not form a complete uniform seal.
In developing a solution to the glove-gown sleeve interface problem, one must understand the procedures of the operating room, constraints of the surgeons, and how PPE is donned.
PPE must not interfere with procedures performed by surgeons and their assistants. PPE should provide: maximum view of the surgeon's hands, maximum ventilation, non-limited sizing, fast time to don and remove, acceptable hoop stress/pressure at hands and wrists, and prevent penetration of infectious or undesirable fluids such as blood, urine, and other bodily fluids.
The surgeon and assistant nurses typically wear a reusable woven fabric or disposable nonwoven fabric gown. The sleeve of the surgical gown is baggy to allow free movement of the user's arms. The end of the sleeve, the stockinet, is typically manufactured with an absorbent material that performs two functions. First, the stockinet provides a comfortable layer that contacts the skin. Secondly, the stockinet is worn around the base of the hand tightly under the glove to provide a means of stabilizing the gown and glove interface during surgery. The surgical gloves are made of elastic synthetic or natural rubber latex. Other PPE includes face shields, masks, goggles, and shoe covers.
After scrubbing, the surgeon dons the surgical gown. The hands remain inside the gown sleeve while an assistant opens the glove cuff opening. The surgeon then pushes his or her hand into the glove, then immediately pushing the hand through the stockinet and into the fingers of the glove. The assistant nurse would then pull the cuff of the surgical glove proximally toward the forearm over the baggy gown sleeve material.
The constriction of the glove cuff (3′) compresses the gown sleeve (2′) against the user's forearm (1′) creating channels (4′) that allow blood to pass through. These channels make the glove-gown sleeve interface the weakest link in surgical PPE. FIG. 19 illustrates the channels.